Independent prior authorization data
The Prior Auth Index
Independent tracking of prior authorization reporting, payer publication status, and workflow-related metrics across U.S. health plans.
Independent
Source-linked
Regularly updated
No payer sponsorship
Operational reporting
Latest Insight
What an Overturned Denial Is Actually Measuring
An overturned prior authorization denial is not a single operational event. It can reflect new documentation, a different interpretation, or external review, but those pathways disappear once the outcome becomes a reported rate.
Read analysis →June 21, 2026 · 5 min read
Payer reporting infrastructure
Explore tracked payer reporting profiles
Search monitored payer and plan reporting profiles, publication status, source-linked disclosures, and machine-readable reporting availability across tracked plans.
Browse all tracked plans →Research publication
The Prior Auth Report
Prior authorization reporting and operational patterns.
Monthly analysis covering payer reporting behavior, operational variation, denial infrastructure, workflow burden, and CMS compliance patterns across U.S. health plans.
Launching July 2026. Early subscribers receive the first issue.
The Prior Auth Report
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Long-form analysis covering payer operations, prior authorization transparency, denial infrastructure, appeals systems, and CMS compliance.
Dataset context
Understanding the dataset
How prior authorization reporting works, what this database tracks, and how to interpret published payer metrics across plans.
What is prior authorization?
Prior authorization is a requirement that clinicians obtain approval from an insurer before certain treatments, procedures, or medications are provided. The insurer reviews the request against applicable criteria and issues a determination. The Prior Auth Index tracks public reporting related to this process, including approval rates, denial rates, decision timelines, appeal outcomes, and source availability.
Reporting scope
Purpose and scope
Prior authorization reporting is now subject to public disclosure requirements under CMS-0057-F. Publication status alone does not establish usability, comparability, or completeness.
Plans report in different formats, at different URLs, with inconsistent definitions and varying levels of granularity. The result is a fragmented public dataset that requires source mapping, normalization, and review before it can be interpreted across plans.
The Prior Auth Index maps source locations, tracks publication status, summarizes available metrics, and identifies limitations in usability and comparability.
Who this is for
The Prior Auth Index is designed for users reviewing prior authorization reporting across operational, policy, and market contexts:
- Revenue cycle and utilization management teams tracking payer reporting patterns
- Consultants and analysts researching prior authorization reporting across markets
- Healthtech operators evaluating payer reporting infrastructure
- Payer strategy and contracting teams reviewing plan-level metrics
- Journalists and researchers studying prior authorization patterns
- Users interpreting published prior authorization reporting
Mapping prior authorization reporting patterns as the public dataset matures.
Plan-level data
Plan-level prior authorization metrics
Denial rates, appeal overturn patterns, and published 2025 metrics across major U.S. health plans, with source-linked disclosures and plan-level reporting context.
2025 metrics
Source-linked disclosures
Plan-level comparisons